A Review on the Role of Low Glycemic Index Foods for Glycemic Control in Chronic Liver Disease

Liver is an essential organ that maintains fasting and postprandial blood glucose response via various metabolic pathways. The liver function gradually deteriorates in chronic liver disease (CLD) due to inflammation and destruction of liver parenchyma. The development of glucose intolerance and hepatogenous diabetes (HD) in patients with CLD is an inevitable event. Diabetes and CLD can coexist, and function synergistically to cause unfavorable clinical consequences, including poor treatment outcomes and frequent hospitalization. The complications associated with liver disease (malnutrition, hypoglycemia, acute kidney injury, lactic acidosis, etc.) and lack of guidelines limit pharmacological management of HD. Dietary recommendations by The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines (2019), suggested weight reducing hypocaloric diet along with adequate branched-chain amino acid (BCAA) and micronutrient consumption to improve steatosis and insulin sensitivity in patients with CLD. Dietary glycemic index controls prognosis of obesity, non-alcoholic fatty liver disease (NAFLD) and diabetes. The importance of low GI diet in reducing fasting blood glucose, hepatic glucose influx and fat accumulation, thereby improving weight loss and NAFLD score, is being published in patients with diabetes or liver disease. Several countries have already incorporated GI into their national health policies, for identification of the nutrient value, resulting in establishment of worldwide GI and glycemic load tables for specific food items. However, the apparent complexity of GI and lack of low GI meal choices need to be resolved in order to enhance patient’s quality of life, health and well-being. Low GI nutritional supplements, comprising of balanced proportion of carbohydrate, protein, BCAAs, fibers and micronutrients, may reduce the complexity related to dietary management of HD. The review summarizes the importance of nutritional management in HD with focus on low GI diet in people with CLD.

Roasted fox nuts (Euryale Ferox L.) contain higher concentration of phenolics, flavonoids, minerals and antioxidants, and exhibit lower Glycemic Index (GI) in human subjects

Fox nut (Euryale ferox) is categorized among superior quality foods because of its highly nutritious profile. It also serves as a good protein source for vegetarian diets. However, it is not widely consumed, due to soggy texture and bland flavor as compared to other nuts. In this study, we used roasting and seasoning to enhance its consumer acceptance. Furthermore, we have also compared biochemical, nutritional and physical properties of the roasted and unroasted fox nuts;and their Glycemic Index (GI) in human subjects. Results showed that roasting significantly (P ≤ 0.05) improved the minerals content (from 0.58 to 0.66%), protein content (from 11.40 to 14.57%), total phenolics (from 346.02 to 470.62 mg GAE/100 g), flavonoids (from 4.15 to 4.43 mg CE/g), 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity (from 48.54 to 79.13% inhibition) and Ferric Reducing Antioxidant Power (from 662.46 to 957.14 μmol FeSO4/g). Consumer acceptance was evaluated with and without seasoning;both salt and spice seasoned roasted nuts had greater overall acceptability as compared to plain roasted and unroasted nuts. Fox nuts also reported low GI (37%) in human subjects (ethical approval #1772/01-06-2020). Thus, roasted fox nuts can be consumed as nutrient rich and low GI snack;not only as a component of healthy diet but can also be served to patients with metabolic disorders like obesity and diabetes.